Low-protein diets in CKD: How can we achieve them? A narrative, pragmatic review

Clinical Kidney Journal

Volumn 8, Issue 1, 2015, Pages 61-70

  Piccoli, Giorgina Barbara ^a   Vigotti, Federica Neve ^a   Leone, Filomena ^a   Capizzi, Irene ^a   Daidola, Germana ^a   Cabiddu, Gianfranca ^b   Avagnina, Paolo ^a  

^a UNIVERSITY OF TURIN   (Italy)

^b BROTZU HOSPITAL   (Italy)

Author keywords

CKD; compliance; keto acids and amino acids; low protein diets; very low protein diets

Indexed keywords

OXOACID;

CHRONIC KIDNEY DISEASE; DIET SUPPLEMENTATION; DIET THERAPY; DIETARY COMPLIANCE; FOOD COMPOSITION; FOOD INTAKE; FOOD QUALITY; GRAIN; HEALTH PROMOTION; HUMAN; KIDNEY FUNCTION; LEGUME; LIFE THREAT; MALNUTRITION; MEDITERRANEAN DIET; NUTRITIONAL STATUS; OVERNUTRITION; PERSONALIZED MEDICINE; POPULATION; PRIORITY JOURNAL; PROTEIN CONTENT; PROTEIN DIET; PROTEIN INTAKE; PROTEIN RESTRICTION; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; TREATMENT INDICATION; VEGAN DIET; VEGETARIAN DIET;

EID: 84926351816     PISSN: 20488505     EISSN: 20488513     Source Type: Journal    
DOI: 10.1093/ckj/sfu125     Document Type: Review

References (119)

1. Mcdonough W, Braungart M. Cradle To Cradle, Remaking The Waywe Make Things. New York: North Point Press, 2002
2. Piccoli Gb. Patient-Based Continuum Of Care In Nephrology: Why Read Thomas Addis' 'glomerular Nephritis' In 2010? J Nephrol 2010; 23: 164-167
3. Addis T, Lew W. Diet And Death In Acute Uremia. J Clin Invest 1939; 18: 773-775
4. Addis T. Glomerular Nephritis: Diagnosis And Treatment. New York: Macmillan, 1949
5. Hostetter Th, Olson Jl, Rennke Hg et al. Hyperfiltration In Remnant Nephrons: A Potentially Adverse Response To Renal Ablation. Am J Physiol 1981; 241: F85-F93
6. Brenner Bm. Nephron Adaptation To Renal Injury Or Ablation. Am J Physiol 1985; 249(3 Pt 2): F324-F337
7. Bergstrom J. Discovery And Rediscovery Of Low Protein Diet. Clin Nephrol 1984; 21: 29-35
8. Mitch We, Remuzzi G. Diets For Patients With Chronic Kidney Disease, Still Worth Prescribing. J Am Soc Nephrol 2004; 15: 234-237
9. Walser M, Mitch We, Maroni Bj et al. Should Protein Intake Be Restricted In Predialysis Patients? Kidney Int 1999; 55: 771-777
10. El Nahas Am, Coles Ga. Dietary Treatment Of Chronic Renal Failure: Ten Unanswered Questions. Lancet 1986; 1: 597-600
11. Giovannetti S, On Behalf Of The Steering Committee Of The European Study Groups For The Conservative Treatment Of Chronic Renal Failure. Answers To Ten Questions On The Dietary Treatment Of Chronic Renal Failure. Lancet 1986; 328: 1140-1142
12. Fouque D, Aparicio M. Eleven Reasons To Control The Protein Intake Of Patients With Chronic Kidney Disease. Nat Clin Pract Nephrol 2007; 3: 383-392
13. Klahr S, Levey As, Beck Gj et al. The Effects Of Dietary Protein Restriction And Blood-Pressure Control On The Progression Of Chronic Renal Disease. Modification Of Diet In Renal Disease Study Group. N Engl J Med 1994; 330: 877-884
14. Levey As, Greene T, Beck Gj et al. Dietary Protein Restriction And The Progression Of Chronic Renal Disease: What Have All Of The Results Of The Mdrd Study Shown? J Am Soc Nephrol 1999; 10: 2426-2439
15. Kopple Jd, Greene T, Chumlea Wcet Al. Relationship Between Nutritional Status And The Glomerular Filtration Rate: Results Fromthe Mdrd Study. Kidney Int 2000; 57: 1688-1703
16. Walser M, Hill S. Can Renal Replacement Be Deferred By A Supplemented Very Low Protein Diet? J Am Soc Nephrol 1999; 10: 110-116
17. Milas Nc, Nowalk Mp, Akpele L et al. Factors Associated With Adherence To The Dietary Protein Intervention In The Modification Of Diet In Renal Disease Study. J Am Diet Assoc 1995; 95: 1295-1300
18. Coyne T, Olson M, Bradham K et al. Dietary Satisfaction Correlated With Adherence In The Modification Of Diet In Renal Disease Study. J Amdiet Assoc 1995; 95: 1301-1306
19. Chen Li, Guh Jy, Wu Kd et al. Modification Of Diet In Renal Disease (Mdrd) Study And Ckd Epidemiology Collaboration (Ckd-Epi) Equations For Taiwanese Adults. Plos One 2014; 9: E99645
20. Fouque D, Laville M. Low Protein Diets For Chronic Kidney Disease In Non Diabetic Adults. Cochrane Database Syst Rev 2009; Cd001892
21. Robertson L, Waugh N, Robertson A. Protein Restriction For Diabetic Renal Disease. Cochrane Database Syst Rev 2007; Cd002181
22. Mccullough Ml, Feskanich D, Stampfer Mj et al. Diet Quality And Major Chronic Disease Risk In Men And Women: Moving Toward Improved Dietary Guidance. Am J Clin Nutr 2002; 76: 1261-1271
23. Sotos-Prieto M, Moreno-Franco B, Ordovás Jm et al. Design And Development Of An Instrument To Measure Overall Lifestyle Habits For Epidemiological Research: The Mediterranean Lifestyle (Medlife) Index. Public Health Nutr 2014; 15: 1-9
24. Dunkler D, Dehghan M, Teo Kk et al. Diet And Kidney Disease In High-Risk Individuals With Type 2 Diabetes Mellitus. Jama Intern Med 2013; 173: 1682-1692
25. Millward Dj, Jackson Aa. Protein/Energy Ratios Of Current Diets In Developed And Developing Countries Compared With A Safe Protein/Energy Ratio: Implications For Recommended Protein And Amino Acid Intakes. Public Health Nutr 2004; 7: 387-405
26. Volpi E, Campbell Ww, Dwyer Jt et al. Is The Optimal Level Of Protein Intake For Older Adults Greater Than The Recommended Dietary Allowance J Gerontol A Biol Sci Med Sci 2013; 68: 677-681
27. Afolabi Pr, Jahoor F, Gibson Nr et al. Response Of Hepatic Proteins To The Lowering Of Habitual Dietary Protein To The Recommended Safe Level Of Intake. Am J Physiol Endocrinol Metab 2004; 287: E327-E330
28. Keys A, Aravanis C, Buchem Fsp et al. The Diet And All-Causes Death Rate In The Seven Countries Study. Lancet 1981; 2: 58-61
29. Trichopoulou A, Lagiou P. Healthy Traditional Mediterranean Diet: An Expression Of Culture, History, And Lifestyle. Nutr Rev 1997; 55(11 Pt 1): 383-389
30. Estruch R, Ros E, Salas-Salvadó J et al. Primary Prevention Of Cardiovascular Disease With A Mediterranean Diet. N Engl J Med 2013; 368: 1279-1290
31. Trichopoulou A, Martínez-González Ma, Tong Ty et al. Definitions And Potential Health Benefits Of The Mediterranean Diet: Views From Experts Around The World. Bmc Med 2014; 12: 112
32. Larsson Sc, Orsini N. Red Meat And Processed Meat Consumption And All-Cause Mortality: A Meta-Analysis. Am J Epidemiol 2014; 179: 282-289
33. Jacobson Mf, Havas S, Mccarter R. Changes In Sodium Levels In Processed And Restaurant Foods, 2005 To 2011. Jama Intern Med 2013; 173: 1285-1291
34. Sylvetsky Ac, Dietz Wh. Nutrient-Content Claims-Guidance Or Cause For Confusion? N Engl J Med 2014; 371: 195-198
35. World Health Organization. Evaluation Of Certain Food Additives. World Health Organ Tech Rep Ser 2012: 1-183, Back Cover
36. Craig Wj, Mangels Ar; American Dietetic Association. Position Of The American Dietetic Association: Vegetarian Diets. J Am Diet Assoc 2009; 109: 1266-1282
37. American Dietetic Association; Dietitians Of Canada. Position Of The American Dietetic Association And Dietitians Of Canada: Vegetarian Diets. Can J Diet Pract Res 2003; 64: 62-81
38. Craig Wj. Nutrition Concerns And Health Effects Of Vegetarian Diets. Nutr Clin Pract 2010; 25: 613-620
39. Zhang J, Liu J, Su J et al. The Effects Of Soy Protein On Chronic Kidney Disease: A Meta-Analysis Of Randomized Controlled Trials. Eur J Clin Nutr 2014; 68: 987-993
40. Barsotti G, Morelli E, Cupisti A et al. A Low-Nitrogen Lowphosphorus Vegan Diet For Patients With Chronic Renal Failure. Nephron 1996; 74: 390-394
41. Soroka N, Silverberg Ds, Greemland M et al. Comparison Of A Vegetable-Based (Soya) And An Animal-Based Low-Protein Diet In Predialysis Chronic Renal Failure Patients. Nephron 1998; 79: 173-180
42. Buzio C, Mutti A, Perazzoli F et al. Protein-Induced Changes In Kidney Function Depend On The Time Of Administration But Not On The Dietary Source. Nephron 1990; 56: 234-240
43. Fujita R, Braun Kl, Hughes Ck. The Traditional Hawaiian Diet: A Review Of The Literature. Pac Health Dialog 2004; 11: 250-259
44. Mckerchar C, Bowers S, Heta C et al. Enhancing M?Ori Food Security Using Traditional Kai. Glob Health Promot 2014; Pii: 1757975914543573 (Epub Ahead Of Print
45. Willcox Bj,Willcox Dc, Todoriki H et al. Caloric Restriction, The Traditional Okinawan Diet, And Healthy Aging: The Diet Of The World's Longest-Lived People And Its Potential Impact On Morbidity And Life Span. Ann N Y Acad Sci 2007; 1114: 434-455
46. Laird Bd, Goncharov Ab, Egeland Gm et al. Dietary Advice On Inuit Traditional Food Use Needs To Balance Benefits And Risks Of Mercury, Selenium, And N3 Fatty Acids. J Nutr 2013; 143: 923-930
47. Li Jr., Hsieh Yh. Traditional Chinese Food Technology And Cuisine. Asia Pac J Clin Nutr 2004; 13: 147-155
48. Webber L, Divajeva D, Marsh T et al. The Future Burden Of Obesity-Related Diseases In The 53 Who European-Region Countries And The Impact Of Effective Interventions: A Modelling Study. Bmj Open 2014; 4: E004787
49. Watson D. Vegan News, No. 1. November, 1944
50. Gilsing Am, Weijenberg Mp, Goldbohm Ra et al. The Netherlands Cohort StudyMeat Investigation Cohort; A Population-Based Cohort Over-Represented With Vegetarians, Pescetarians And Low Meat Consumers. Nutr J 2013; 12: 156
51. Lewis Ds. On The Influence Of A Diet With High Protein Content On The Kidney. Can Med Assoc J 1921; 11: 682-683
52. Mackay Ll, Addis T, Mackay Em. The Degree Of Compensatory Renal Hypertrophy Following Unilateral Nephrectomy: Ii. The Influence Of The Protein Intake. J Exp Med 1938; 67: 515-519
53. Borst Jg. Protein Katabolism In Uraemia; Effects Of Proteinfree Diet, Infections, And Blood-Transfusions. Lancet 1948; 1: 824-829
54. Giovannetti S, Maggiore Q. A Low-Nitrogen Diet With Proteins Of High Biological Value For Severe Chronic Uraemia. Lancet 1964; 1: 1000-1003
55. Kerr Nd, Robson A, Ashcroft R. Diet In Chronic Renal Failure. Proc R Soc Med 1967; 60: 115-116
56. Berlyne Gm, Janabi Km, Shaw Ab. Dietary Treatment Of Chronic Renal Failure. Proc R Soc Med 1966; 59: 665-667
57. Wright Pl, Brereton Pj, Snell Dem. Effectiveness Of Modified Giovannetti Diet Compared With Mixed Low-Protein Diet. Metabolism 1970; 19: 201-213
58. Hood Cea, Beale Dj, Housley J et al. Dialysed Egg As Nitrogen Source In Dietary Control Of Chronic Renal Failure. Lancet 1969; 1: 479-482
59. Franklin Ss, Gordon A, Kleeman Cr et al. Use Of A Balanced Low-Protein Diet In Chronic Renal Failure. Jama 1967; 202: 477-484
60. Berlyne Gm, Gaan D, Ginks Wr. Dietary Treatment Of Chronic Renal Failure. Am J Clin Nutr 1968; 21: 547-552
61. Giordano C, Pluvio M, Di Guida G et al. Modulated Nitrogen Intake For Patients On Low-Protein Diets. Am J Clin Nutr 1980; 33: 1638-1641
62. Guarnieri G, Faccini L, Lipartiti Tet Al. Simple Methods For Nutritional Assessment In Hemodialyzed Patients. Am J Clin Nutr 1980; 33: 1598-1607
63. Johnson Dw. Dietary Protein Restriction As A Treatment For Slowing Chronic Kidney Disease Progression: The Case Against. Nephrology (Carlton) 2006; 11: 58-62
64. Maroni Bj. Protein Restriction Andmalnutrition In Renal Disease: Fact Or Fiction? Miner Electrolyte Metab 1997; 23: 225-228
65. Maiorca R, Brunori G, Viola Bf et al. Diet Or Dialysis In The Elderly The Dode Study: A Prospective Randomized Multicenter Trial. J Nephrol 2000; 13: 267-270
66. Brunori G, Viola Bf, Parrinello G et al. Efficacy And Safety Of A Very-Low-Protein Diet When Postponing Dialysis In The Elderly: A Prospective Randomized Multicenter Controlled Study. Am J Kidney Dis 2007; 49: 569-580
67. Scalone L, Borghetti F, Brunori G et al. Cost-Benefit Analysis Of Supplemented Very Low-Protein Diet Versus Dialysis In Elderly Ckd5 Patients. Nephrol Dial Transplant 2010; 25: 907-913
68. Friedman An. New Evidence For An Old Strategy To Help Delay The Need For Dialysis. Am J Kidney Dis 2007; 49: 563-565
69. Piccoli Gb, Ferraresi M, Deagostini Mc et al. Vegetarian Lowprotein Diets Supplemented With Keto Analogues: A Niche For The Few Or An Option For Many Nephrol Dial Transplant 2013; 28: 2295-2305
70. Piccoli Gb, Deagostini Mc, Vigotti Fn et al. Which Low-Protein Diet For Which Ckd Patient? An Observational, Personalized Approach. Nutrition 2014; 30: 992-999
71. Mircescu G, Gərnea L, Stancu Sh et al. Effects Of A Supplemented Hypoproteic Diet In Chronic Kidney Disease. J Ren Nutr 2007; 17: 179-188
72. Cianciaruso B, Pota A, Pisani A et al. Metabolic Effects Of Two Low Protein Diets In Chronic Kidney Disease Stage 4-5-A Randomized Controlled Trial. Nephrol Dial Transplant 2008; 23: 636-644
73. Zeller K, Whittaker E, Sullivan L et al. Effect Of Restricting Dietary Protein On The Progression Of Renal Failure In Patients With Insulin-Dependent Diabetes Mellitus. N Engl J Med 1991; 324: 78-84
74. Combe C, Deforges-Lasseur C, Caix J et al. Compliance And Effects Of Nutritional Treatment On Progression And Metabolic Disorders Of Chronic Renal Failure. Nephrol Dial Transplant 1993; 8: 412-418
75. Giordano M, Ciarambino T, Castellino P et al. Light And Shadows Of Dietary Protein Restriction In Elderly With Chronic Kidney Disease. Nutrition 2013; 29: 1090-1093
76. Thilly N. Low-Protein Diet In Chronic Kidney Disease: From Questions Of Effectiveness To Those Of Feasibility. Nephrol Dial Transplant 2013; 28: 2203-2205
77. Paes-Barreto Jg, Silva Mi, Qureshi Ar et al. Can Renal Nutrition Education Improve Adherence To A Low-Protein Diet In Patients With Stages 3 To 5 Chronic Kidney Disease J Ren Nutr 2013; 23: 164-171
78. Cianciaruso B, Capuano A, D'amaro E et al. Dietary Compliance To A Low Protein And Phosphate Diet In Patients With Chronic Renal Failure. Kidney Int Suppl 1989; 27: S173-S176
79. Gray Ja. The Shift To Personalised And Population Medicine. Lancet 2013; 382: 200-201
80. Kitsios Gd, Kent Dm. Personalised Medicine: Not Just In Our Genes. Bmj 2012; 344: E2161
81. Basch E. Toward Patient-Centered Drug Development In Oncology. N Engl J Med 2013; 369: 397-400
82. Lin Ga. Patient Education: One Size Does Not Fit All. Jama Intern Med. 2013; 173: 1376
83. Verhoef Mj, Lewith G, Ritenbaugh C et al. Complementary And Alternative Medicine Whole Systems Research: Beyond Identification Of Inadequacies Of The Rct. Complement Ther Med 2005; 13: 206-212
84. Black N. Why We Need Observational Studies To Evaluate The Effectiveness Of Health Care. Bmj 1996; 312: 1215-1218
85. Benson K, Hartz Aj. A Comparison Of Observational Studies And Randomized, Controlled Trials. N Engl J Med 2000; 342: 1878-1886
86. Concato J, Shah N, Horwitz Ri. Randomized, Controlled Trials, Observational Studies, And The Hierarchy Of Research Designs. N Engl J Med 2000; 342: 1887-1892
87. Barton S. Which Clinical Studies Provide The Best Evidence The Best Rct Still Trumps The Best Observational Study. Bmj 2000; 321: 255-256
88. Piccoli Gb. The Never-Ending Search For The Perfect Dialysis. Should We Move From The Best Treatment To The Best System? Nephrol Dial Transplant 2011; 26: 1128-1131.
89. Stenvinkel P, Heimbürger O, Lindholm B et al. Are There Two Types Of Malnutrition In Chronic Renal Failure Evidence For Relationships Between Malnutrition, Inflammation And Atherosclerosis (Mia Syndrome).Nephrol Dial Transplant 2000; 15: 953-960
90. Abraham G, Varsha P, Mathew M et al. Malnutrition And Nutritional Therapy Of Chronic Kidney Disease In Developing Countries: The Asian Perspective. Adv Ren Replace Ther 2003; 10: 213-221
91. Aparicio M, Bellizzi V, Chauveau P et al. Keto Acid Therapy In Predialysis Chronic Kidney Disease Patients: Final Consensus. J Ren Nutr 2012; 22(2 Suppl): S22-S24
92. Oba S, Nagata C, Nakamura K et al. Diet Based On The Japanese Food Guide Spinning Top And Subsequent Mortality Among Men And Women In A General Japanese Population. J Am Diet Assoc 2009; 109: 1540-1547
93. Chauveau P, Combe C, Fouque D et al. Vegetarianism: Advantages And Drawbacks In Patients With Chronic Kidney Diseases. J Ren Nutr 2013; 23: 399-405
94. Liou Hh. What Can A Keto Acid/Amino Acid-Supplemented Protein-Restricted Diet Do For The 'butterfly Effect' In Chronic Kidney Disease Patients? J Rennutr 2009; 19(5 Suppl):S15-S18
95. Walser M, Mitch We, Abras E. Supplements Containing Amino Acids And Keto Acids In The Treatment Of Chronic Uremia. Kidney Int Suppl 1983; 16: S285-S289
96. Schefold Jc, Zeden Jp, Fotopoulou C et al. Increased Indoleamine 2,3-Dioxygenase (Ido) Activity And Elevated Serum Levels Of Tryptophan Catabolites In Patients With Chronic Kidney Disease: A Possible Link Between Chronic Inflammation And Uraemic Symptoms. Nephrol Dial Transplant 2009; 24: 1901-1908
97. Sallée M, Dou L, Cerini C et al. The Aryl Hydrocarbon Receptor-Activating Effect Of Uremic Toxins From Tryptophan Metabolism: A New Concept To Understand Cardiovascular Complications Of Chronic Kidney Disease. Toxins (Basel) 2014; 6: 934-949
98. Piccoli Gb, Attini R, Vasario E et al. Vegetarian Supplemented Low-Protein Diets. A Safe Option For Pregnant Ckd Patients: Report Of 12 Pregnancies In 11 Patients. Nephrol Dial Transplant 2011; 26: 196-205
99. Piccoli Gb, Leone F, Attini R et al. Association Of Low-Protein Supplemented Diets With Fetal Growth In Pregnant Women With Ckd. Clin J Am Soc Nephrol 2014; 9: 864-873
100. Piccoli Gb, Motta D, Martina G et al. Low-Protein Vegetarian Diet With Alpha-Chetoanalogues Prior To Pre-Emptive Pancreaskidney Transplantation. Rev Diabet Stud 2004; 1: 95-102
101. Piccoli Gb, Guzzo G, Vigotti Fn et al. Tailoring Dialysis And Resuming Low-Protein Diets May Favor Chronic Dialysis Discontinuation: Report On Three Cases. Hemodial Int 2014; 18: 590-595
102. D'alessandro C, Rossi A, Innocenti M et al. Dietary Protein Restriction For Renal Patients: Don't Forget Protein-Free Foods. J Ren Nutr 2013; 23: 367-371
103. Wu Hl, Sung Jm, Kao Md et al. Nonprotein Calorie Supplement Improves Adherence To Low-Protein Diet And Exerts Beneficial Responses On Renal Function In Chronic Kidney Disease. J Ren Nutr 2013; 23: 271-276
104. Kovesdy Cp, Kopple Jd, Kalantar-Zadeh K. Management Of Protein-Energy Wasting In Non-Dialysis-Dependent Chronic Kidney Disease: Reconciling Low Protein Intake With Nutritional Therapy. Am J Clin Nutr 2013; 97: 1163-1177
105. Garneata L, Mircescu G. Effect Of Low-Protein Diet Supplemented With Keto Acids On Progression Of Chronic Kidney Disease. J Ren Nutr 2013; 23: 210-213
106. Walser M, Hill S, Tomalis Ea. Treatment Of Nephrotic Adults With A Supplemented, Very Low-Protein Diet. Am J Kidney Dis 1996; 28: 354-364
107. D'amico G, Remuzzi G, Maschio G et al. Effect Of Dietary Proteins And Lipids In Patients With Membranous Nephropathy And Nephrotic Syndrome. Clin Nephrol 1991; 35: 237-242
108. Anderson Jw, Blake Je, Turner J et al. Effects Of Soy Protein On Renal Function And Proteinuria In Patients With Type 2 Diabetes. Am J Clin Nutr 1998; 68(6 Suppl): 1347S-1353S
109. Azadbakht L, Esmaillzadeh A. Soy-Protein Consumption And Kidney-Related Biomarkers Among Type 2 Diabetics: A Crossover, Randomized Clinical Trial. J Ren Nutr 2009; 19: 479-486
110. Cupisti A, Ghiadoni L, D'alessandro C et al. Soy Protein Diet Improves Endothelial Dysfunction In Renal Transplant Patients. Nephrol Dial Transplant 2007; 22: 229-234
111. Moe Sm, Zidehsarai Mp, Chambers Ma et al. Vegetarian Compared With Meat Dietary Protein Source And Phosphorus Homeostasis In Chronic Kidney Disease. Clin J Am Soc Nephrol 2011; 6: 257-264
112. Cupisti A, Morelli E, Meola M et al. Vegetarian Diet Alternated With Conventional Low-Protein Diet For Patients With Chronic Renal Failure. J Ren Nutr 2002; 12: 32-37
113. Giordano M, Ciarambino T, Castellino P et al. Long-Term Effects Of Moderate Protein Diet On Renal Function And Low-Grade Inflammation In Older Adults With Type 2 Diabetes And Chronic Kidney Disease. Nutrition 2014; 30: 1045-1049
114. Cupisti A, Kalantar-Zadeh K. Management Of Natural And Added Dietary Phosphorus Burden In Kidney Disease. Semin Nephrol 2013; 33: 180-190
115. Kalantar-Zadeh K, Gutekunst L, Mehrotra R et al. Understanding Sources Of Dietary Phosphorus In The Treatment Of Patients With Chronic Kidney Disease. Clin J Am Soc Nephrol 2010; 5: 519-530
116. Sarathy S, Sullivan C, Leon Jb et al. Fast Food, Phosphoruscontaining Additives, And The Renal Diet. J Ren Nutr 2008; 18: 466-470
117. Sherman Ra, Mehta O. Phosphorus And Potassium Content Of Enhanced Meat And Poultry Products: Implications For Patients Who Receive Dialysis. Clin J Am Soc Nephrol 2009; 4: 1370-1373
118. Middleton Jp, Lehrich Rw. Prescriptions For Dietary Sodium In Patients With Chronic Kidney Disease: How Will This Shake Out? Kidney Int 2014; 86: 457-459
119. Aaron Kj, Sanders Pw. Role Of Dietary Salt And Potassium Intake In Cardiovascular Health And Disease: A Review Of The Evidence. Mayo Clin Proc 2013; 88: 987-995